丙泊酚复合氯胺酮在先天性髋关节脱位手术的麻醉体会

目的探讨小儿先天性髋关节脱位手术麻醉方法的安全性。方法择期手术患儿53例,ASA分级Ⅰ级,年齡1～5岁,采用丙泊酚复合氯胺酮静脉麻醉,麻醉诱导:丙泊酚1.5mg/kg,氯胺酮1mg/kg。麻醉维持:丙泊酚2～3mg(/kg.h),氯胺酮2～4mg/(kg.h)持续微量泵静注,术中面罩给氧。观察血压,脉搏,血氧饱和度。结果术中血压脉搏平稳,无呼吸抑制,恶心呕吐2例,苏醒期轻度躁动4例。结论丙泊酚复合氯胺酮微量泵静注用于小儿先天性髋关节脱位手术,麻醉效果良好,呼吸循环稳定,具有一定的临床应用价值。

Experience of propofol combined with ketamine for congenital dislocation of the hip anesthesia treatment

Objective To explore the safety of congenital dislocation of the hip anesthesia treatment in pediatric patients.Methods 53 pediatric patients(ASA Ⅰ,1-5years)who underwent elective operations,used propofol combined with ketamine for anesthetic induction,the dose of propofol and ketamine was 1.5 mg/kg and 1 mg/kg.Used injection pump to continuous intravenous inject propofol 2-3 mg/(kg.h)and ketamine 2-4 mg/(kg.h)for maintenance of anesthesia,supplied oxygen by mask in the operation.Blood pressure,heart rate and pulse oxygen saturation were observed.Results Intraoperative blood pressure and heart rate were stable.There had no incidence of respiratory depression.Two cases of nausea and vomiting and four cases of restlessness in the waking time happened.Conclusion There can obtain satisfact effect of anesthesia,stable respiration and circulation state by the way of using injection pump to intravenous inject propofol combined with ketamine in pediatric patients who undergo operations of congenital dislocation of the hip.It had clinical application value.